Application of endoscopic retrograde cholangiopancreatography drainage in surgical treatment of hilar cholangiocarcinomas

Abstract

Objective To explore the feasibility, efficacy and safety of endoscopic retrograde cholangiopancreatography(ERCP) drainage during peroperation of hilar cholangiocarcinoma for alleviate jaundice. Methods Nineteen cases patients with hilar cholangiocarcinoma who were treated with ERCP in the First Affiliated Hospital of Xi'an Jiao Tong University from January 2013 to December 2013, the drainage way, efficient rate, complication rate, and surgical situation were retrospective analyzed. Results Bilateral endoscopic drainage was one-time achieved in all 19 patients.Among them, Eendoscopic nasobiliary drainage(ENBD) for unilateral bilateral drainage was 4 cases, ENBD and plastic stent for unilateral(left or right) drainage was 9 cases, ENBD and plastic stent for bilateral drainage was 6 cases.The drainage efficiency rate was 89.5% (17/19). Serum alanine aminotransferase(ALT), total bilirubin(TBIL), direct bilirubin(DBIL), alkaline phosphatase(ALP) and Prothrombin time (PT) were significantly decreased after 7days post-ERCP((208.4±47.7) U/L vs.(90.3±31.57) U/L, (421.7±85.9) μmol/L vs.(150.1±49.7) μmol/L, (294.6±30.6) μmol/L vs.(95.4±23.2) μmol/L, (853.1±133.7) U/L vs.(600.0±116.4) U/L, (17.7±1.8) s vs.(13.8±1.0) s; P=0.000, 0.001, 0.000, 0.001, 0.004). There were 6 cases occurred ERCP postoperative complications, including 2 cases of hyperamylasemia, 1 case of pancreatitis, 3 cases of cholangitis.Seven cases of hilar cholangiocarcinoma patients were received hilar radical surgery by combination caudate lobectomy of the left or right hepatectomy, no postoperative cholangitis was occurred. Conclusion ERCP biliary drainage is an important means to ensure the perioperative safety and efficacy of hilar cholangiocarcinoma. Key words: Endoscopic retrograde cholangiopancreatography; Biliary drainage; Hilar cholangiocarcinomas